Claim for equine insurance
I submitted a claim under an equine insurance policy for mortality and this is particurlarly an event where the underwriters have failed to appoint an independent vet despite being notified but have refused the claim. In summary:
3. HUMANE DESTRUCTION means:
a) that the HORSE incurs an injury or is afflicted with an excessively painful disease, and a VETERINARY SURGEON appointed by the Underwriters shall first have given a certificate that the suffering of the HORSE is incurable and so excessive that immediate destruction is imperative for humane reasons;
The underwriters were notified that the horse suffered an injury with a special mention “broke down” (injury) along with an official stipe report which reported that the club vet reported that the horse broke down. The underwriters hence had plenty of opportunity from the 7th of September to appoint a vet, as per the above clause. The underwriters chose NOT to appoint a vet.
As for condition 3(b):
that the HORSE incurs an injury and a VETERINARY SURGEON appointed by the INSURED shall first have given a certificate that the suffering of the HORSE is incurable and so excessive that immediate destruction is imperative for humane reasons without waiting for the appointment of a VETERINARY SURGEON by the Underwriters.
The stipes reported that the club vet reported that the horse “broke down”, which is clearly a situation that demanded humane euthanasia.
Both these conditions have passed the test for a successul claim.
Do I have a case for a claim?
Hello. You have the right to demand reasons why the claim was refused. If you are not satisfied with the reasons you may then approach the long term insurance Ombudsman or sue them. You will find the detail of the Ombudsman online. The key words here in the agreement are 1) Incurable 2) So excessive, and 3) Imperative. These should form the basis of the Vets report for a good case.